Aesthetic evaluation of orthodontic management of missing maxillary lateral incisors

The most common maxillary lateral incisor agenesis (MLIA) orthodontic management options are space closure or space reopening and implant placement. This study aimed to 1. Examine and compare the aesthetic evaluation patterns of orthodontists, dentists, and laypeople for ``good'' and ``bad'' cases of MLIA treated with space closure, space reopening, and implant placement; 2. Determine if ``good'' and ``bad'' cases were scored differently within each group; and 3. Investigate potential gender differences in aesthetic evaluations.

A questionnaire was completed by 57 orthodontists, 75 dentists, and 85 laypeople. Participants ranked images of treated MLIA cases on a 1 to 10 scale and identified the best and worst outcomes. Nonparametric statistical analyses (Kruskal-Wallis, Friedman, and Mann-Whitney U tests) were employed for both descriptive and inferential analyses.

Laypeople assigned statistically significantly higher ratings to ``bad'' images of both treatment modalities than orthodontists and dentists. Significant differences were found in the comparisons of `good' and `bad' images for both treatment types within the orthodontist and dentist groups. However, statistically significant differences were observed only among laypersons for space opening. Statistically significant sex differences were found among laypeople scoring ``bad'' cases for both treatment approaches.

Dentists and orthodontists can differentiate between good and bad results of closed and open treatments, but laypeople only do so in open cases. Laypeople tend to assign better scores than orthodontists and dentists, and when they are men, they are less critical than women of unesthetic results.